title: Recipient damage after musculocutaneous transplant rejection.
abstract: BACKGROUND
  In the event of a composite allograft failure, damage to the recipient tissues may make retransplantation impossible. This study aimed to quantify the damage after composite allograft failure to assess whether retransplantation is feasible.
  
  
  METHODS
  Rats (n=6) in the group I received composite musculocutaneous flap allotransplants (WF-->Lew) with immunosuppression allowing healing-in of the allograft before being tapered allowing rejection. At full rejection, the recipient vascular pedicle was examined, biopsies of the recipient tissue bed were taken and graded for damage, and in vitro assays were performed. Groups II (allograft without immunosuppression, n=7), III (isograft with immunosuppression, n=5), and IV (isograft without immunosuppression, n=6) were included to attempt to identify the contributions of the rejection process, immunosuppression, and healing to recipient tissue damage.
  
  
  RESULTS
  The vascular pedicle was patent to within 1 mm of the anastomosis in all rejected allografts. Furthermore, it was possible to retransplant after full rejection. There was minimal damage to the recipient tissues at the time of full rejection in group I. In contrast, group II had significantly more damage (P<0.05) to recipient muscle and skin. This correlated with more severe immune reaction with more than 100 times antibody production in group II compared with group I. Groups III and IV had little recipient tissue damage.
  
  
  CONCLUSIONS
  These results suggest that it is possible to retransplant after rejection of a musculocutaneous transplant while on immunosuppression. Furthermore, the second transplant will not be limited in form or function by recipient tissue bed damage.
authors.affiliation: Plastic Surgery Research Laboratory, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, CNY, Boston, MA 02114, USA.
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Horner
authors.forename: Kyle R
authors.initials: KR
authors.lastname: Eberlin
authors.forename: Kelly K
authors.initials: KK
authors.lastname: Ferguson
authors.forename: Erica L
authors.initials: EL
authors.lastname: Hirsh
authors.forename: Mark A
authors.initials: MA
authors.lastname: Randolph
authors.forename: Peter E M
authors.initials: PE
authors.lastname: Butler
mesh_terms: D000818:Animals; D001808:Blood Vessels / Q000473:pathology; D004195:Disease Models, Animal; D006084:Graft Rejection / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D018482:Muscle, Skeletal / Q000098:blood supply / Q000637:transplantation*; D051381:Rats; D011917:Rats, Inbred Lew; D011920:Rats, Inbred WF; D012086:Reoperation; D012867:Skin / Q000098:blood supply; D016038:Skin Transplantation / Q000009:adverse effects*; D013524:Surgical Flaps / Q000009:adverse effects*; D016559:Tacrolimus / Q000008:administration & dosage; D014184:Transplantation, Homologous; D014185:Transplantation, Isogeneic; D014945:Wound Healing
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus